Provider Demographics
NPI:1902175979
Name:RAINBOW'S END RECOVERY CENTER LLC
Entity Type:Organization
Organization Name:RAINBOW'S END RECOVERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DEL COLLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-879-2267
Mailing Address - Street 1:PO BOX 1146
Mailing Address - Street 2:
Mailing Address - City:CHALLIS
Mailing Address - State:ID
Mailing Address - Zip Code:83226-1146
Mailing Address - Country:US
Mailing Address - Phone:208-879-2267
Mailing Address - Fax:208-879-2089
Practice Address - Street 1:25341 N. HIGHWAY 93
Practice Address - Street 2:
Practice Address - City:CHALLIS
Practice Address - State:ID
Practice Address - Zip Code:83226
Practice Address - Country:US
Practice Address - Phone:208-879-2267
Practice Address - Fax:208-879-2089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility